Provider networks, premiums drive health plan choices

When given a choice, most Americans with traditional health coverage say they chose that option because it offered a good network of providers, according to research findings by the not-for-profit Employee Benefit Research Institute (EBRI).

In contrast, among those with high-deductible consumer-driven health plans, most cited the lower premiums and opportunity to save money in a health savings account (HSA) or health reimbursement arrangement (HRA).

While close to half of all private-sector workers who have health insurance are offered a choice of health plans, most of those with a choice work for large firms, according to the report, Health Plan Choice: Findings from the 2011 EBRI/MGA Consumer Engagement in Health Care Survey, published in the July 2012 issue of EBRI Notes.

“Most Americans get their health insurance coverage from employment-based plans, yet most employers do not offer a choice of health plans,” said Paul Fronstin, director of EBRI’s Health Research and Education Program and author of the report. “Health plan choices are likely to expand via the expansion of insurance exchanges under the Patient Protection and Affordable Care Act, so it’s important to know how people make their decisions when they do have a choice.”

Among the report's key findings:

• Half of consumer-driven health plan enrollees reported that they chose that offering because of the lower premium, while 45% reported that the opportunity to save money in the account for future years was a primary reason.

• Among individuals with traditional health coverage, 39% cited the good network of providers and 32% reported the low out-of-pocket costs as the main reasons for enrolling in the plan.

There was no difference in satisfaction with ease of getting an appointment with a doctor or choice of doctors between those enrolled in a consumer-directed health plan and traditional plan enrollees. However, enrollees in a high-deductible health plan without a spending account were less likely than traditional plan enrollees to be extremely or very satisfied in these areas.

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